Pima County is moving forward with a plan to improve its contact tracing efforts for COVID-19 and will add 127 full-time employees to assist in virus investigations.
In one of her first moves as the newly appointed public health director, Dr. Terry Cullen developed the expanded contact tracing plan as a way to continue minimizing the spread of coronavirus throughout the county. The plan, which included requests for an increase in workers and resources, were approved by County Administrator Chuck Huckelberry last week. Proposal requests will be issued to local organizations to help fill these needs.
The cost of the expanded contact tracing effort is expected to be reimbursed through federal emergency COVID-19 funding, Huckelberry said.
โItโs clear from many different public health experts, including the CDC, that contact tracing is a critical part of trying to stop the pandemic and stop the spread of the disease,โ Cullen said. โThe county has done a very good job with this so far. But we recognize that we need to increase our level of effort.โ
Before the pandemic began, the Health Departmentโs investigation team was made up of six epidemiology staff members.
Once COVID-19 presented itself in Pima County, the department assigned 17 additional staff members to the effort and enlisted the help of 11 retired health-care volunteers and students from the University of Arizona, which equates to the work of 24 full-time employees.
โOur increased staff is currently unable to meet the increased CDI needs of COVID-19 in a timely manner. Our goal is to significantly expand our ability to achieve timely and effective contact tracing to ensure the goal of the current pandemic,โ Cullen wrote in the plan. โTo meet this goal ... we have estimated the overall need for 16 โmanagersโ and 140 contact tracers for a 6 month period.โ
According to Cullen, 29 of these positions will be filled by department staff and volunteers. To find out just how many more people and resources they needed to track the virus, the Pima County Health Department used a workforce calculator developed by public health experts at Johns Hopkins through the Resolve to Save Lives Initiative.
With the current number of contact tracers, Cullen said the department is able to initiate case reports for 68% of cases within a 2 day period. By increasing staff, they aim to conduct initial interviews with 80% of cases within 48 hours of receiving the positive report. In addition, they hope to be able to identify and notify contacts of exposure and test at least 75% of symptomatic contacts within 48 hours.
In addition to an increase in staff, the plan also includes improvements in protocols and will require contact tracers to take up to 20 hours of training, where they will learn to ask more in-depth questions when conducting their interviews.
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The plan also addresses the unique needs of long-term care facilities and other congregate settings, who have been the most impacted by the virus in Pima County.
โWeโve got to ask more probing questions than we have been,โ said Dr. Bob England, acting Pima County health director, in a public health update. โWeโve got to identify clusters of cases quicker so that we can intervene more efficiently in workplace outbreaks or congregate setting outbreaks.โ
Cullen said she also wants this plan to focus heavily on data and transparency and is hoping to be able to develop a metric that will show how many of the positive cases have been contacted daily.
โI come from a big data background and weโre going to figure out what data would be helpful to people and get on some type of routine with that,โ she said.
Even with an expanded plan, there are still a number of challenges when it comes to contact tracing, according to England and Cullen.
By the time Pima County receives the report from a provider or facility, the contact tracer has to reach out to those places to obtain the patientโs phone number and other identifying information if not already provided. Then, the contact tracer has to actually get a hold of the patient, which provides a challenge on its own.
โWe need people that have been identified as potential contacts to understand that our discussions with them are really to help assess for them, whether theyโre personally at risk, if they have any signs of that disease and if they need a referral pattern to get tested. But itโs also the educational part and letting them know what those symptoms are and what we need them to watch for. And ideally, we would check in on every person, every day for 14 days.โ
Cullen said this really depends on people actually picking up the phone or responding to mailed letters. To help with this effort, a number of investigators will also be assigned to make house visits when they arenโt able to reach someone by phone.
Delays in testing still remain a significant challenge for contact tracing efforts as well. Cullen said the Health Department is continuously looking for ways to improve that process.
โThis isnโt going to be perfect,โ England said. โYou just got to expect thereโs going to be leaking around the edges no matter how well we do this and how hard we try.โ
Photos: Peaceful protests and violent clashes in downtown Tucson
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A person throws an object towards the Tucson Police Department line near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A protestor in a wheelchair tries to get away from tear gas near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A pedestrian walks past closed and covered locally owned business Flash in the Past Studio and Shop, 43 S. 6th. Ave., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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Pieces of wood, decorated with Ben's Bells be kind symbol, cover up windows at Cartel Coffee Lab, 210 E. Broadway Blvd., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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A person reacts after getting hit with pepper bullets fired on a crowd confronting Tucson Police on 7th Street near 6th Avenue after a peaceful demonstration turned violent on the second night of protests in Tucson, Ariz., May 31, 2020.
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A person dares Tucson Police to hit him with pepper bullets as a few hundred confront law enforcement along 7th Street between 5th and 6th Avenues as things turn violent on the second night of protests in Tucson, Ariz., May 31, 2020.
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A protestor grabs a selfie with a line of Tucson Police officers in riot gear holding a line against a several dozen protestors at the underpass on 4th Avenue on the second night of protests in Tucson, Ariz., May 30, 2020.
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A woman stands in the spotlights from Tucson Police holding a line against a hundred or so protestors along 7th Street as the night's demonstration turned violent on the second night of protests in Tucson, Ariz., May 31, 2020.
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A man sprays an accelerant onto a fire in trash container dragged onto 6th Street by dozens of protestors moving through the streets on the second night of protests in Tucson, Ariz., May 31, 2020.
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A man gets water poured onto his face after Tucson Police fired tear gas onto a line of protestors shielding behind several vehicles on 7th Street and 5th Avenue on the second night of protests in Tucson, Ariz., May 31, 2020.
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Several protestors advance through the haze of expended pepper bullets on the line of Tucson Police holding them at bay on 7th Street near 6th Avenue on the second night of protests in Tucson, Ariz., May 31, 2020.
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A dumpster burns along 7th Street besides Miller's Surplus after protestors set in on fire and wheeled it toward a line of Tucson Police on the second night of protests in Tucson, Ariz., May 31, 2020.
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Two men advancing on a line of Tucson Police try to shelter behind a paper sign as they are pelted with dozens of pepper bullets on the second night of protests in Tucson, Ariz., May 30, 2020.
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Protestors hurl construction signage and barriers onto 6th Street as they retreat from Tucson Police on the second night of protests in Tucson, Ariz., May 31, 2020.
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Tucson Police Department officers approach a dumpster lit on fire by people near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A man tries to set fire to a small branch near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A dumpster set on fire by people scene next to Miller's Surplus near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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People move a segment of fencing to a make shift barricade near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A police officer uncuffs a person following during a traffic stop following the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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An officer talks with a cuffed person following the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A person is put in cuffs by a police officer following the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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People ride on the back of a car as they leave 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A man steps away from tear gas fumes set off near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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Two men hold street signs to block projectiles shot by police officers near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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Tucson Police Department officers clear an alley of people near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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A man reacts after trying to light a branch on fire multiple times while protesting near 6th Avenue and 7th Street during the second night of protests in Tucson, on May 30, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis.
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About 500 gather outside along Stone Avenue at the Tucson Police headquarters on the second night of protests in Tucson, Ariz., May 30, 2020.
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A motorist stuck on 5th Avenue by the 500 or so protestors streaming east on Broadway gets cell phone video of the crowd flowing by on the second night of protests in Tucson, Ariz., May 30, 2020.
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Approximately 500 protestors head north on Stone Avenue after gathering briefly in front of the Tucson Police headquarters on the second night of protests in Tucson, Ariz., May 30, 2020.
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Protestors sit in the middle of 6th Avenue at 14th Street, briefly blocking traffic on the second night of protests in Tucson, Ariz., May 30, 2020.
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A handful of protestors sit on the curb outside the Tucson Police Department headquarters early on the second night of protests in Tucson, Ariz., May 30, 2020.
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Danitza Hernandez paints Be Kind in Spanish on the window of Scented Lear on East Congress Saturday, preparing on the second night of protests in Tucson, Ariz., May 30, 2020. A loose group of local neighbors and residents were painting the symbols on the windows of downtown buildings hoping it would help to keep roving bands of protestors from smashing the glass.
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LeCaire Whitfield, left, Patrick Swartz and John Krikawa board the windows on their Krikawa Master Jewelers preparing for the worst on the second night of protests in Tucson, Ariz., May 30, 2020.
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A woman walks down the line of riot gear clad officers guarding the Tucson Police headquarters as about 500 protestors gather briefly in the street on the second night of protests in Tucson, Ariz., May 30, 2020.
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A woman passively confronts a row of Tucson, Ariz., Police as they advance their line a few yards at the corner of Cushing and Church, May 28, 2020, during a protest in the wake of nationwide anger following the death earlier in the week of George Floyd in Minneapolis.
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A man attempts to talk to the line of Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020, during a large protest of the death earlier in the week of George Floyd in Minneapolis.
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A dozen protestors take seats in front of a line Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020, during a large scale protest in the wake of the death of George Floyd in Minneapolis.
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A protestor uses a construction barrel he dragged in as an easy chair to face off with Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020, in the wake of nationwide anger following the death of George Floyd in Minneapolis.
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A man attempts to talk with Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020, during a large scale protest in the wake of the death of George Floyd in Minneapolis.
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A woman sits in front of one of two lines of Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020, in the wake of nationwide anger following the death of George Floyd in Minneapolis.
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A woman raises her hands as she approaches a line of Tucson, Ariz., Police, at the corner of Cushing and Church, May 28, 2020, during a protest in the wake of nationwide anger following the death earlier in the week of George Floyd in Minneapolis.
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A couple of people sit in the windows of homes sprayed with protest graffiti as a few hundred protestors face off with Tucson, Ariz., Police at the corner of Cushing and Church, May 28, 2020.
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A man pours water at the feet of Tucson, Ariz., Police as a few hundred protestors at the corner of Cushing and Church, May 28, 2020, show their anger following the death of George Floyd in Minneapolis.
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A woman asks for a hug from the line of Tucson, Ariz., Police confronting protestors at the corner of Cushing and Church, May 28, 2020, during a demonstration in the wake of the death of George Floyd in Minneapolis.
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A protester vents at a line of Tucson Police Officers in riot gear at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester holds a sign up in remembrance of George Floyd during a demonstration at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester raises hands in the air while turning away from a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A line of Tucson Police Officers in riot gear at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protesters stand off against a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Tucson Police Officers in riot gear stand at Cushing Street and Church Ave. while facing off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department dressed in riot gear stand at Cushing Street and Church Ave. as the face off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protestors stand off against a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Two officers from the Tucson Police Department whisper to one another while a group of roughly 300 protestors stands in front of them at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protesters stand off against a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester tries to talk with an officer from the Tucson Police Department while demonstrating at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester tears up while facing off against police officers at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Shattered windows on the TEP building in downtown Tucson from a protest that took place on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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People photograph dumpsters set ablaze on Broadway during a protest in downtown Tucson, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A man looks out a broken window of Charro Steak after the several windows were broken during a demonstration in downtown Tucson, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Hotel staff sweep up broken glass after several windows of the AC Hotel were damaged during a protest in downtown Tucson, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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People board up Charro Steak's windows after they were broken during a demonstration, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protesters stand off against a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protesters stand off against a line of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department dressed in riot gear stand at Cushing Street and Church Ave. as the face off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester vents at a line of Tucson Police Officers in riot gear at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department dressed in riot gear stand at Cushing Street and Church Ave. as the face off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department dressed in riot gear stand at Cushing Street and Church Ave. as the face off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester tries to talk with an officer from the Tucson Police Department while demonstrating at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester tries to talk with an officer from the Tucson Police Department while demonstrating at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department dressed in riot gear stand at Cushing Street and Church Ave. as the face off against a group of about 300 protesters, on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester yells at officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester keeps her hands raised in a peaceful manner in front of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. Close to 300 people took part in a protest that was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester takes a photo of an officer from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. Close to 300 people took part in a protest that was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Protesters stand in silence with their arms raised in front of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester lit and threw a firecracker in front of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. Close to 300 people took part in a protest that was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester holds up her sign in front of officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. Close to 300 people took part in a protest that was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester yells at officers from the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A protester lights a bundle of sage during a protest near the Tucson Police Department at Cushing Street and Church Ave. on May 29, 2020. Close to 300 people took part in a protest that was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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Officers from the Tucson Police Department stand shoulder to shoulder to form a line and face off with about 300 protesters near the depatment's headquarters at 270 S Stone Ave. on May 29, 2020. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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The Tucson Police Department headquarters at 270 S Stone Ave. was tagged during a protest on May 29, 2020, in Tucson, Ariz. The protest in Tucson was similar to those in numerous cities across the United States following the police killing of George Floyd in Minneapolis earlier this week.
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A pedestrian walks their bike past the Fox Theater, 17 W. Congress St., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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Broken glass remains in front of a broken window at One West Broadway, 1 W. Broadway Blvd., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson.
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The refection of a Tucson Police Department vehicle shows in the decorated doors of The Rialto Theater, 318 E. Congress St., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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Pedestrians walk past covered windows of Charro Steak, 188 E. Broadway Blvd., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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A pedestrians walks past covered and decorated windows of Charro Steak, 188 E. Broadway Blvd., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
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A sign informing the public about Club Congress is taped on a door at Hotel Congress, 311 Congress St., in Tucson, Ariz. on May 31, 2020. Tucson businesses and buildings in downtown were vandalized after the second day of protests in Tucson. In response, businesses placed signs on doors informing the public that businesses were locally owned.
